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She is Secretary of State. The United States Secretary of State is the head of the United States Department of State, concerned with foreign affairs. The Secretary is a member of the Cabinet and the highest-ranking cabinet secretary both in line of succession and order of precedence http://en.wikipedia.org/wiki/United_States_Secretary_of_State
Met a woman living with HIV. Had recently given birth to baby boy. Wanted baby to get good start in life → went to clinic throughout pregnancy → received medication & information →baby HIV-free + mother receives ttt → will see child grow
- Last year alone helped prevent 114,000babies from being born with HIV
- Have brought together key partners→ global plan for eliminating new infections among children by 2015
- Integrate prevention & ttt→ healthy children + safe delivery
- Must include voluntary medical male circumcision. Low cost procedure → proven reduction of risk of female-to-male transmission (>60%). Life-long benefit
- 1,000,000 men circumcised since 2007 worldwide for prevention. ¾ funded by PEPFAR. Kenya & Tanzania: 35,000/month
- Ideal intervention:
- prevention from infection
- no mother-to-child transmission
- ttt of infected people with antiretroviral drugs
- 96% reduction of transmission to partner
- Some people do not take medication as directed → not maximum protection
- Fear that scaling up ttt will detract from prevention efforts. Now → comprehensive view of pb: ttt adds to prevention→ Ttt AS prevention!
Expensive but reduction of cost of ttt
- lower cost of drugs now
- bulk purchasing → ↘ prices
- shipping by ground rather than air → ↘ prices
2004: ≈$ 1,000/yr, today: $ 335 & ↘
People can work, support their families, contribute to their communities. It averts social costs, e.g: caring for orphans whose parents die of AIDS-related illnesses. Treating people: will save lives+ generate considerable economic returns
Concern: many people transmit virus to others shortly after they have acquired it themselves, but before they have begun treatment. Legitimate concern. Studying ways to identify people sooner after transmission and help them avoid spreading the virus further.
Where pandemic well established (most Sub-Saharan African countries), most transmissions ← people with longstanding HIV infections who need treatment. Tests are available, need to identify these people. If they receive and maintain their treatment, their health will improve dramatically, and they will be far less likely to transmit the virus to their partners.
Interventions must be used in combination. more people are becoming infected every year than are starting treatment. Trend can be reversed. Mathematical models show that scaling up combination prevention to realistic levels in high-prevalence countries would ↘ worldwide rate of new infections by at least 40 to 60 %. That’s on top of the 25 % drop already seen in the past decade. → number of new infections will ↘. → it will be possible to treat more people than are becoming infected each year→ will be on the path to an AIDS-free generation.
- To be able to deliver them not just in hospitals, but in clinics located in communities of every size and shape
- Need to let science guide our efforts. Success depends on deploying our tools based on the best available evidence
United States is using scientifically proven results to inform policy,→ real change for programs on the ground and ↗ impact of investments
- Need more research to identify the most effective ways to combine these interventions in different contexts
- Complex pandemic that varies from country to country, district to district, from urban areas to rural → Combination prevention needs to reflect this complexity
- Already working to answer these questions. Recently granted more than $50 million to three of the world’s leading academic institutions to develop rigorous studies that test what works in various settings
- The United States, through PEPFAR, will commit an additional $60 million to rapidly scale up combination prevention in parts of four countries in Sub-Saharan Africa and to rigorously measure the impact
- Results will have implications for every country where we work and for our partners as well. → Translating science into services that deliver the most impact. Will→ bigger steps together in march toward an AIDS-free generation
- Other donors should join in this effort
- Go out and find partner countries to test most effective combinations of tools. Scale up support for treating as many people as possible. Measure the impact and share the results, so we can all learn from each other
- Put more emphasis on country ownership of HIV/AIDS programs. We can’t create an AIDS-free generation by dictating solutions from Washington. In-country partners –governments, NGOs, and faith-based organizations – need to own and lead their nation’s response. → strengthen their health systems so they can take on an even broader range of health problems
- More partner countries need to share more responsibility for funding fight against HIV/AIDS within their borders. More countries need to follow South Africa, Nigeria, Senegal, Rwanda, Zambia, and others that are committing larger shares of their own budgets to HIV/AIDS
- Calling on other donor nations to do their part
- Obligation to do what we can
Transcript
Extrait de Can You? Testez vos connaissances en anglais de la santé
Félicie Pastore Ellipses 2013 ISBN 9782729881542